二次侮辱的流行,同时发生和与严重TBI后的结果的关系
Joseph Donnelly1,2,3, Erta Beqiri1, Frederick A Zeiler4,5,6,7,8
1Brain Physics Laboratory Division of Neurosurgery Department of Clinical Neurosciences, University of Cambridge, UK.
Brain & spine
|January 8, 2025
概括
严重创伤性脑损伤 (TBI) 后,像高内压 (ICP) 和低脑 perfusion 压 (CPP) 这样的二次侮辱是常见的. 与单个侮辱相比,联合侮辱显著恶化了患者的预后.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
背景情况:
- 严重的创伤性脑损伤 (TBI) 可以导致影响内压力 (ICP),脑 perfusion 压力 (CPP) 和压力反应 (PRx) 的二次侮辱.
- 这些次要的侮辱是TBI后患者结果的已知预测因素.
研究的目的:
- 确定严重TBI患者中与ICP,CPP和PRx相关的二次侮辱的患病率,同时发生率和预后意义.
- 调查孤立和联合二次侮辱对TBI后死亡率的影响.
主要方法:
- 分析了一组需要ICP监测的严重TBI患者队列.
- 二次侮辱被定义为长时间 (≥1小时) 的高ICP (>20 mmHg),低CPP (<60 mmHg) 或受损PRx (>0.25) 的持续时间.
- 后勤回归模型评估了不同类型的二次侮辱和死亡率之间的关联.
主要成果:
- 在76%的患者中出现了升高的ICP,在92%的患者中出现了 PRx 干扰,在55%的患者中出现了低CPP,至少持续了一个小时.
- 大约40%的监测时间至少涉及一次次要侮辱.
- 联合侮辱 (ICP,CPP和PRx) 与孤立侮辱相比,死亡率的几率比率 (1.17) 更高.
结论:
- 与ICP,CPP和自我调节相关的二次侮辱非常普遍,并且在严重的TBI后经常独立发生.
- 损伤的ICP,CPP和PRx的同时出现显著预示着预后比单独的疾病更糟糕.
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